Frequently Asked QuestionsMethadone, Buprenorphine and Vivitrol®

No – Medication-Assisted Treatment with buprenorphine and methadone are not heroin/opioid substitutes. They are prescribed or administered under monitored, controlled conditions, and are safe and effective for treatment of opioid addiction when used as directed. They help to stabilize the opioid system in the body.

Yes, methadone is safe when taken as prescribed and has been in use as a primary addiction treatment for over 40 years. Some patients may experience side effects like constipation or increased sweating. However, these side effects often lessen or resolve once a patient becomes stabilized on their methadone dose.

The length of time that a patient will remain on methadone will vary based upon the unique needs of each individual. Although methadone is safe for long-term use, patients are not required to remain on this medication long-term. Although some patients will remain on methadone for long-term maintenance, others will only utilize it short-term. Patients should work closely with their physician in order to comfortably wean off of their medication. Once a patient’s system is free from methadone, he or she may transition onto a different medication or remain medication-free.

This varies from person to person. Once on a stable dose of methadone many patients report not feeling sick if they miss a dose. Methadone has a much longer half life than most other opioid medications, and therefore is present and active in the body well beyond a 24 hour period. For this reason, some patients remain comfortable and do not experience withdrawal symptoms following a single missed dose. However, the metabolism of each person is different, and some patients may in fact begin to experience the onset of withdrawal if they miss a dose. It is always best to plan for daily dosing and to avoid missing a dose if at all possible.

Yes, it is considered safe for a pregnant women to take methadone. Methadone is considered the standard of care for pregnant opioid- addicted women. By being maintained on methadone, the mother and fetus will not be stressed by repetitive withdrawal symptoms. The mother will be in a stable state, which also means the baby is in a stable state.

No, your baby is not "addicted" after birth. However, because your baby is physically dependent on methadone and will withdraw after birth, the withdrawal may or may not result in clinical symptoms of neonatal abstinence syndrome (NAS). NAS is a treatable condition and multiple studies have found no long-term health concerns for babies born with NAS.

Because methadone can negatively interact with other medications, it is important for patients to openly discuss the use of other medications and/or substances with their physician and inform the methadone clinic doctor during your intake. Patients are also advised to refrain from using opioids, benzodiazepines and alcohol during the course of treatment, due to the potentially dangerous effects that can take place when combined with methadone.

It is possible for an individual to overdose on methadone, and overdose can be fatal. Mixing methadone with other sedatives or pain medications should never be attempted without first consulting with a physician. An overdose is less likely to occur while taking buprenorphine. Doses higher than 24-32 mg of buprenorphine will usually not increase the opioid effect.

Medical studies indicate that methadone does not harm the body's tissues and does not produce tooth decay. Dental problems experienced by recovering people are usually the result of accumulated health neglect that occurred during the active addiction period.

Buprenorphine is a synthetic partial opioid which attaches to the opioid receptors on the brain. It has a stronger bond with the opioid receptors than other opioids. This helps block the effect of opioids, may reduce cravings and may reduce withdrawal symptoms.

If the buprenorphine is taken first then the buprenorphine may help block the effect of the opioid. If someone is actively using other opioids and takes buprenorphine, it may cause sudden and severe withdrawal.

Yes, it is safe for a pregnant woman to take buprenorphine. By being maintained on buprenorphine the mother and fetus will not be stressed by repetitive withdrawal symptoms. The mother will be in a stable state which also means the baby is in a stable state.

Vivitrol® attaches to the opioid receptors in the brain and blocks opioids from attaching to the those receptors. This results in someone not being able to feel the effects of opioids. After you receive a dose of VIVITROL®, its blocking effect slowly decreases and is completely eliminated over time.

If someone tries to overcome the blocking effect of Vivitrol® by taking large amounts of opioid, it can lead to serious injury, coma, or death. As the blocking effect slowly decreases over the course of the month, use of any opioid drugs increase the risk of overdose. Also, the risk of overdose or death is high in those who stop Vivitrol® and then reuse opioid drugs. Individuals may be unaware of their loss of tolerance while on Vivitrol®, and misjudge the effects of even a small amount of opioids.

Use of medication to treat opioid use disorder usually provided in a certified, licensed OTP or a physician’s office-based treatment setting, that provides maintenance pharmacotherapy using an opioid agonist (methadone), a partial agonist (buprenorphine), or an antagonist (naltrexone) medication, which is combined with other comprehensive treatment services, including medical and psychosocial services.